The many faces of post- traumatic stress
The stories of military veterans suffering from PTSD are well known — but research suggests other groups of people may suffer from the disorder at higher rates.
Kalina Christoff felt overwhelmed and pressured to accept medical procedures she didn’t want during the birth of her first child, a “dehumanizing” experience that led to anxiety and flashbacks. Jenn Baerg ended an abusive engagement, then had panic attacks and anxiety as she relived being molested by a family member during her teens and early 20s.
Christoff and Baerg are the other faces of post- traumatic stress disorder. Their struggles are less well known than PTSD among military personnel, war veterans and first responders, whose dramatic stories make good headlines. But studies show certain groups, like mothers with birth trauma, sexual assault victims and members of First Nations, often have higher rates of PTSD than the military.
Experts say nobody is immune to PTSD – all it takes is a traumatic event or a series of such events.
“When it comes to the actual diagnosis, there’s no difference ( in the cause),” said Daniel Cox, an assistant professor in the counselling psychology program at the University of B. C. “An event is an event, whether it’s a firefight in the military or a car accident on the Burrard Bridge.”
Descriptions of people being traumatized by dramatic events have been documented since the times of the ancient Greeks, usually in connection with war. But the term post- traumatic stress disorder didn’t exist until 1980. That year it was included for the first time in the Diagnostic and Statistical Manual of Mental Disorders, the authoritative classification tool for psychiatrists. The definition has evolved over the years, with the latest change in 2013 adding sexual assault to the types of events that can trigger the disorder.
According to the American Psychiatric Association, PTSD occurs when a person experiences, witnesses, or is repeatedly exposed to “threatened death, serious injury or sexual violation.”
The Canadian Mental Health Association says of PTSD: “Something is traumatic when it is very frightening, overwhelming and causes a lot of distress.
“Trauma is often unexpected, and many people say that they felt powerless to stop or change the event. Traumatic events may include crimes, natural disasters, accidents, war or conflict, or other threats to life. It could be an event or situation that you experience yourself or something that happens to others, including loved ones.”
Both descriptions ring true for Christoff, an associate professor of psychology at the University of B. C., who was 35 when she gave birth to her first child at a Vancouver- area hospital in 2010. She said she was distressed, frightened and overwhelmed at the way she was treated by medical personnel, but worse, she felt powerless to stop the juggernaut of medical procedures that doctors seemed determined to perform.
She said the doctors expressed concern about her unborn child’s heartbeat and increasingly insisted on the necessity of using forceps in the birth, but refused to say what the heartbeat was or explain the risks of forceps. As the doctors grew increasingly angry at her questions and resistance, she said she finally consented out of fear about what would happen to her and her baby if she didn’t.
She regretted it immediately. “At the sound of that ‘ OK,’ all 15 medical people in the room swarmed onto me, one person covered my raised legs with a blue sheet, so I couldn’t see anything of what was happening,” she recounted on a website she has started about birth trauma. “Because of the epidural, I couldn’t feel anything either. I didn’t see, hear or feel the birth of my child. No one told me he was born, and no one showed him to me.”
A later review of her medical records showed the baby’s heartbeat was fine and there was no need to use forceps, she said on her website, adding that an effort to seek an explanation and apology from one of the doctors involved was turned down. But the damage was done. “Both my baby and I sustained physical injuries from the forceps that we struggled with greatly during the first month after the birth. But much worse and longer lasting were the psychological injuries.”
She developed trauma and then severe PTSD. “I wasn’t traumatized because the birth itself was painful or scary, I was traumatized because of the way I was treated during the birth … it basically dehumanized me.”
For sexual abuse survivors like Baerg, who agreed to be named for this story, the trauma was suffered over a period of time in her younger years. PTSD emerged later, triggered by specific events.
For Baerg, that occurred in 2008, when she broke her engagement to a fiance who was both physically and verbally abusive.
She was 26 and breakup prompted her to reflect on the underlying issue of her abuse by a family member.
“This led to me having unhealthy relationships with men afterwards,” she said.
Baerg and Christoff each developed at least some of the symptoms of PTSD, which include nightmares, flashbacks, feelings of anger, anxiety and irritability, problems sleeping, drug and alcohol dependency and a general numbness.
Christoff was also troubled by people’s lack of sympathy. “People around me didn’t want to hear what I said,” she said, adding some would say: “Don’t complain, you have a healthy baby.”
“It’s a really difficult process because depending on the trauma, oftentimes the people who are traumatized might be encouraged not to remember.”
Baerg said her symptoms included anxiety, unpredictable panic attacks and sensitivity to physical contact. She recalled that something as innocuous as an ex- boyfriend touching her on the back once triggered an anxiety attack.
“It could even be harder for other people in my life,” she said of the disorder. “I can’t tell you when that hug will be not be OK.”
Another sexual assault survivor, Nicole Marcia, said her PTSD symptoms took the form of addictions.
“I was a very heavy drinker, a very heavy drug user, a very heavy smoker, I was engaged in a lot of sort of risky behaviours,” said Marcia, who was assaulted by a neighbour when she was in her early 20s. “All of which at the time I didn’t realize were very common methods of selfregulation for people who have experienced trauma.”
People with PTSD aren’t doomed. A variety of treatments are available, although their effectiveness varies according to the individual and the type of PTSD involved. Traditional treatments include counselling and medication, but alternative methods such as float tanks, holistic medicine, marijuana, ecstasy, meditation and yoga are also being tested.